Radiographic Assessment of Successful Lumbar Spinal Fusion: A Systematic Review of Fusion Criteria in Randomized Trials

作者：Alexander Yu, Justin Tiao, Charlene W. Cai, Jonathan Huang, Kareem S. Mohamed, Ryan Hoang, James Won‐Ki Hong, Daniel Berman, Joshua Lee, Luca Ambrosio, Zorica Buser, Juan P. Cabrera, Xiaolong Chen, Chiara Cini, Stipe Ćorluka, Andreas K. Demetriades, Ashish D. Diwan, Amit Jain, Jin-Sung Kim, Xudong Li, Sathish Muthu, Javad Tavakoli, Gianluca Vadalà, Patrick C. Hsieh, Samuel K. Cho, AO Spine Knowledge Forum Degenerative · 发表于：Global Spine Journal · 年份：2025 · DOI：10.1177/21925682251384662 · 被引用次数：9 · 研究领域：Spine and Intervertebral Disc Pathology、Spinal Fractures and Fixation Techniques、Medical Imaging and Analysis

Study TypeSystematic Scoping Review.IntroductionRadiographic assessment is crucial for diagnosing symptomatic pseudarthrosis and evaluating spinal fusion outcomes, yet no consensus exists on defining successful lumbar fusion. This scoping review presents criteria for imaging-based assessment after posterolateral and interbody lumbar fusion, aiming to guide consistent evaluation methods.MethodsFollowing PRISMA guidelines, a comprehensive search of Medline, Embase, and Scopus identified eligible randomized controlled trials and Federal Drug Administration clinical trials involving lumbar fusion. Studies on revision surgeries, non-lumbar fusions, adult spinal deformity, traumatic fractures, tumors, infections, or lacking defined fusion assessment methods were excluded. Data extraction focused on classification and descriptive systems of fusion evaluation, analyzing parameters such as bony bridging, angular motion, translation, hardware failure, cage migration, radiolucency, and cleft within the fusion mass.ResultsA total of 142 articles (1995-2024) were reviewed. Computerized tomography was the most common imaging modality (102, 71.8%), followed by static (96, 67.6%) and dynamic radiographs (88, 62%). Descriptive criteria were used in 108 studies (76.1%) and classification systems in 47 (33.1%). Interbody fusion was assessed in 90 articles (63.4%) and posterolateral fusion in 68 (47.9%). Bony bridging continuity was the most reported descriptive criterion (105, 73.9%), followed ...